The Patients' Bill of Goods

Michael Arnold Glueck, M.D., is a multiple award-winning writer who comments on medical-legal issues. Robert J. Cihak, M.D., is a former president of the Association of American Physicians and Surgeons. Both doctors are Harvard-trained diagnostic radiologists.

This is a patients’ heads-up alert! As the current TV commercial for Mercedes reminds us, things are not always as they seem.

So it is with the much ballyhooed “Patients Bill of Rights” – which, if it were honestly labeled, would be called more accurately the “Patients’ Bill of Goods,” or better yet the “Trial Lawyers’ Compensation” act (TLC for attorneys). It has virtually nothing to do with patient care, other than raising the insurance premiums for you and your family.

In the coming days, the U.S. House of Representatives will be asked to vote on the so-called Dingell-Ganske-Norwood Patients Bill of Rights. It’s a proposal that will lead to unlimited lawsuits, will force small businesses to cut back or eliminate employee health coverage, and lead to higher health-care costs overall. The only winners will be the personal injury lawyers – and their crocodile wallets – behind the lawsuits.

For starters, this legislation, while claiming to target managed care, would also subject employers that provide health care to being named as co-defendants in lawsuits. In other words, any employer that provides health coverage to employees through a managed care company would be at risk of a lawsuit. Worse, the legislation provides for virtually unlimited
damages in these suits, meaning a business could be completely wiped out with just a single legal action. What employer would be crazy enough to offer such a benefit?

Congress should think about that very carefully. According to a 1999 survey of 600 large U.S. employers, many employers say they’d have to cut health benefits for fear they could be named as defendants in lawsuits against HMOs. That’s large employers, but what about the small and mid-size businesses that provide millions of jobs for working Americans? These smaller businesses can’t risk an astronomical damage award that would force them to close their doors. They would have no choice but to drop coverage for their employees.

The clear result is that America would then have even more people without health coverage. Is that really in the best interest of the nation? For example in California, it has been reported that the number of people without health-care increases by 23,000 a month, a rate that vastly outpaces every other state.

Proponents of the Dingell-Ganske-Norwood Personal Injury Lawyers’ Bill of Rights would argue that these employers could simply take the money saved by not providing health coverage and give it to their employees to purchase their own. But how far is that money really going to go when health plans will keep raising their premiums to keep pace with litigation?

The fact that litigation would drive up the cost of health care is no secret. The Jan. 27, 2000, issue of the New England Journal of Medicine, discussing the litigation of cases against managed care stated, “Two outcomes are certain: millions of dollars will go toward attorneys fees, and these costs will need to be paid, at least in part, out of health insurance premiums.” In actuality the increased costs will be in the billions. The specter of higher health-care premiums comes with its own set of negatives.

According to a study published in the Journal of Health Economics, every 10 percent increase in the cost of health insurance creates a three to four percent decrease in the number of people who choose to purchase coverage. Again, we end up with fewer Americans who have health coverage, but more personal injury lawyers who have more money.

To put a figure to the impact of the Dingell-Ganske-Norwood Personal Injury Lawyers’ Bill of Rights, the Employment Policy Foundation recently release a study that paints a disturbing picture. According to the study, this kind of legislation could lead to 56,000 new lawsuits per year, $16 billion in higher health-care costs and 9 million more Americans without health coverage.

Incredibly, the American Medical Association – not missing another chance to make a really bad decision and further tarnish their image and sully their little remaining reputation – has joined hands and elbows with the trial lawyers in supporting this measure. To do this is na?ve, shortsighted and just plain foolhardy. The AMA must have Alzheimer’s disease. How pitifully soon they have forgotten it was the trial lawyers that gave rise to almost all the current patient and physicians woes. If and when the PBOR passes, the lawyers will desert and betray the AMA and physicians by naming them as well every time they sue an HMO or managed-care organization. When you make a pact with the devil and sell yourself to Satan, not surprisingly you surface in the same space!

Maryann Maloney is executive director of Orange County Citizens Against Lawsuit Abuse (OCCALA), a nonprofit, grass-roots, public-education organization. Maloney notes, “The objective of the civil justice system is to provide justice – not pursue greed. Under this deceptive bill we all pay and we all lose – except for the trial lawyers. What America needs is
more and better health care, not more lawsuits.”

The Dingell-Ganske-Norwood proposal will do nothing to improve the quality of health care and in fact will make access to quality care more difficult for more people. Surely Congress should recognize that Dingell-Norwood is not the answer. If better health care is truly the objective, and not bigger paychecks for personal injury lawyers, then we can find a solution that addresses the real problem without hurting small and large businesses, raising the cost of health care, and leaving more Americans uninsured without care or medications.

In the case of the seriously ill Patients’ Bill of Rights – what you see and hear – is not what you will get.